The Christie NHS FT Annual Report & Accounts 2019-20

The Christie NHS Foundation Trust Annual Report & Accounts 2019-20

Lack of documented discussion with patients and families around goals of care; partial and late completion of an ‘Allow and Natural Death’ forms Missed opportunity for earlier referral to supportive and palliative care team All consultants receive feedback following a review of one of their patients. Aspects of good practice are also highlighted. Any concerns identified are also shared within directorates or more widely,

especially if associated with an incident or complaint. Examples of learning from these mortality reviews:

• New SOP developed to ensure that the procedures unit (interventional radiology) are alerted to diabetic patients, and that the wards are clear on pre- procedural requirements such as fasting. • Review of responsible consultant documentation (for example, when patient is admitted for procedure under the pain team) • Amendment to electronic noting, so consultant attendance and board rounds are captured, clearer instructions on handover to another team, and discussions regarding goals of care documented. • New fluid balance forms monitoring from 12am-12am instead of 7am-7am has improved documentation and accuracy. • Guidance is being developed for junior doctors and oncology teams on when and how to access a surgical opinion • Quality improvement initiative to review and improve the clinical pathways and inpatient care for interventional radiology procedures • Electronic chemotherapy risk form developed to improve handover of complex chemotherapy patients Performance against key indicators The Christie aims to meet all national targets and priorities. We have provided an overview of the national targets and minimum standards including those set out within Monitor’s Compliance Framework below. The indicators "18 Week Targets - 18 week incomplete pathways" and "Cancer Targets - % of cancer patients waiting a maximum 62 days from GP referral to first definitive treatment including rare and testicular cancers (based on the GM&C reallocated position, and also on the new national allocation position)" in the table below have not been subject to external assurance this year from our auditors due to the COVID-19 Pandemic.

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